The full story...

Doctors concerned at decline in pap smears

EMILY BOURKE: New figures from South Australia show a drop in the number of pap smears being conducted in that state over the past year.

Experts say the trend is similar across the country and could have something to do with the rollout of a vaccine for the viruses which cause cervical cancer.

Some in the medical profession say they're worried what that might mean for tackling the disease.

Rebecca Brice reports.

REBECCA BRICE: The advent of the Gardasil vaccine was hailed as a breakthrough in the fight against cervical cancer, but it's having some unexpected side effects.

Dr Tonia Mezzini from the Adelaide Women's Health Centre is increasingly encountering women who believe they don't need the test.

TONIA MEZZINI: I'd often speak to young women you know about other health care concerns particularly, you know, in the course of a contraceptive consult and I'll say to them, you know, have you had a pap smear and they say, oh well no I've had the vaccine.

REBECCA BRICE: The rate of pap smears in young women has been steadily decreasing in South Australia since 2006. To 2010, the rate for women aged 20 to 24 had dropped by 5 per cent to 45 per cent.

The latest figures show another 7,200 women in South Australia dropped out of testing in the 2011-2012 financial year.

The trend in South Australia is being reflected nationally. Figures from the Australian Institute of Health and Welfare show a fall Australia-wide of 5 per cent also.

Joe Tooma from the Australian Cervical Cancer Foundation.

JOE TOOMA: It seems I think anecdotally that most of the girls have now had vaccinations for cervical cancer but they don't seem to be informed or realise or perhaps have forgotten that it only covers them for about 70 or 80 per cent of the potential of cervical cancer because it only covers the two major virus types that cause cervical cancer and not 10 or 12 others that can potentially cause cervical cancer.

REBECCA BRICE: He's concerned about the consequences, reinforcing the message that the vaccine, while extremely effective, doesn't prevent all types of cervical cancer.

JOE TOOMA: The research that I've seen says that as a general number in the community, something like 43 per cent of women do not have their pap test regularly and we've seen other research that says 90 per cent of women who die from cervical cancer will be in that 43 per cent who have not had their regular pap tests. So that's a frightening figure.

REBECCA BRICE: Dr Mezzini agrees.

Are you worried about what might happen if this trend isn't reversed?

TONIA MEZZINI: Yes and there's quite a few of us who work in women's health who are starting to be a little bit nervous about the decline in participation rates in screening.

REBECCA BRICE: Dr Margaret Davy is a surgeon at the Royal Adelaide Hospital and a member of the cervical screening program with SA Health. She says the success of the state's 20 year pap smear campaign could also be contributing.

MARGARET DAVY: Here in South Australia we had 100 new cases of cervix cancer each year. Ten years after the project had been initiated, we were down to 45 to 50 new cases each year.

So the program has been very successful and it may well be that part of that success is that women are not so aware in their local communities of other women having cervix cancer and so it loses some of the fear factor.

REBECCA BRICE: Joe Tooma says at the end of the day the issue is getting the message out to young women.

JOE TOOMA: Look, there's not a lot of general information out there, it's certainly not a subject that you see covered a lot in the media and it's one of our major objectives is to try and get awareness out there to Australian women of all ages from 18 through to 80 that they need to have pap tests as recommended, which is every two years, unless their doctor says otherwise.